Drug resistance keeps malaria threat alive in India

Dr P L Joshi, faculty, National Institute for Health and Family Welfare (NIHFW), New Delhi, points out that apart from having the support of external agencies, developing nations must have their own redressal mechanism in place. Appreciating the fundings from World Bank and technical guidance from WHO, he says unless a proper preventive mechanism is enforced, it will be difficult to tackle the menace. "The government of India has stepped up its efforts. This is clearly visible from the change in the drug policy. There are various programs educating people about the preventive measures. In place of small projects a decade ago, there are currently projects worth $89 million (Rs 500 crore) focusing on malarial research," he adds.

Many awareness programs are being run by the government through media and various NGOs. Ranbaxy has launched an action malaria campaign that includes patient awareness and education, and assistance to physicians in diagnosis and treatment of malaria.

Fresh hopes

The unavailability of options has created need for new anti-malarial drugs that can tackle these challenges. The success of phase III trials of a GSK vaccine, which the company has been developing along with PATH Malaria Vaccine Initiative, has raised the hopes of an anti-malarial vaccine. GSK has already invested $300 milion in the project and will invest further $50 million to $100 million in it.

In India, Ranbaxy has developed Arterolane maleate, a rapidly acting drug in combination with long-acting piperaquine phosphate. It has also developed a New Chemical Entity, Arterolane, in combination with Piperaquine, which is expected to have superior benefits over the currently available anti-malarial therapies. According to sources in Ranbaxy, the drug has received approval from the Indian Health authorities and the product is in line with WHO recommendations.Research done by Dr Virander Chauhan and Dr Chetan Chitnis at the International Centre for Genetic Engineering & Biotechnology (ICGEB) has led to the developement of a first generation vaccine, MJAIVAC1, which is based on combination of two merozoite antigens (MSP-119 and EBA-175). The vaccine is presently being tested for safety and immunogenicity in a phase I clinical trial, the first for a malaria vaccine developed in India. The ICGEB has also developed a portfolio of novel antigens that is currently at different stages of pre-clinical development. Also, the center has developed a vaccine, PvDBPII, for Plasmodium vivax and it is being produced by a biotechnology company for phase I trial.

Under a government-funded project, Mumbai-based IPCA Labs, along with Jamia Hamdard University, New Delhi, has developed a genetically modified variety of Artemisinin Annua that can generate high yield of Artemisinin. Once approved, the variety will be put to confined-field trials for evaluation and then patented and commercialized for cultivation by farmers. The group expects that this variety will fetch more than one percent Artemisinin in field trials.